Countries yet to introduce rotavirus vaccine despite proven impact

News Hour:

Rotavirus is one of the several viruses known to cause a self-limited gastroenteritis. Fluid stool losses may be dramatic, and death from dehydration is not uncommon, particularly in developing countries. More than 80 percent of children infected by 5 years of age. In 2013, rotavirus killed 215,000 young children worldwide. But how to prevent this?

Vaccines are the best way to prevent severe rotavirus infections and the deadly, dehydrating diarrhea they can cause. Around 40 percent of the diarrheas in the world are due to rotavirus.

If you live in a rich country with good health care, with good water supply, if it gets too serious, you can take the child to a hospital. But it is very much different if you live in a country where the nearest health center might be three hours walking.

In 2006, Nicaragua was the first low-income country to introduce rotavirus vaccines – the same year as the United States. Typically, rotavirus was the first cause of hospitalization due to severe and serious diarrhea in Nicaragua before the introduction of the vaccine. There were around 30,000 cases of diarrhea. After 6 months of distributing the vaccine, the number of children that needed help decreased so much that they had to close the pediatric diarrhea ward for a few months in some hospitals.

For the prevention of diarrheal disease, it is necessary to have an integrated strategy that involves oral rehydration salts, appropriate hygienic sanitary measures at home, micronutrients like the use of zinc, and clean water.

56 percent of the global rotavirus deaths occur in countries of sub-Saharan Africa. Prior to vaccine introduction, more than 2,000 children in Ghana died from rotavirus each year. New vaccine introduction can be difficult in low-income countries. But in 2012, Ghana was among the first sub-Saharan African countries to introduce rotavirus vaccine. They needed to create advocacy. They needed to get the epidemiological data. The government set up an implementation group involving researchers, people from the ministry, the media, the food, and drugs authority. Everybody came together.

With the introduction of the vaccine, they noticed a decrease in diarrheal diseases among children under 5, especially in the hospital setting. In the first three years after Ghana introduced the rotavirus vaccine, the percentage of diarrhea hospitalizations positive for rotavirus fell by 49 percent.

Ghana is a role model in the sense that other countries can be advised and encouraged to follow their example of vaccine introduction.

In Malawi, rotavirus used to kill more than 2,500 young children per year. Scientists in Malawi generated clinical trial data needed to support the World Health Organization’s 2009 recommendation for global rotavirus vaccine introduction.

Malawi is one of the countries that has been proactive in the fight against diseases. Between 2007 and 2009, the WHO did a clinical trial where the rotavirus vaccine was tested. They found a significant reduction in the number of children with severe rotavirus diarrhea.

Malawi introduced rotavirus vaccines in October 2012. So most of their infants have been vaccinated with the rotavirus vaccine and this has made a big impact.

Just two years after Malawi’s introduction, rotavirus hospital admissions fell by 43 percent. The example of Malawi should be continued disseminating the results so that countries that have not yet started or embarked on this must come on board.

The countries that have introduced this vaccine can see a very important reduction in hospitalization and death. Rotavirus vaccines are saving lives and improving health in countries where they have been introduced as part of the routine childhood immunization program.

If we invest in these vaccination programs among these young children, you will find that they will not be admitted to the hospital. If they are not admitted, the burden of work in the hospitals will be reduced, the health system will have some savings that can be used for other health burdens.

We will be doing a big disservice to our children if we do not get these vaccines to them. No child should die from diarrhea. Yet 60 million infants live in low-income countries – mostly in Asia – that have not introduced rotavirus vaccines. If we can’t talk about it, we can’t defeat it.

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Dr. Tareq Salahuddin is a Special Correspondent of News Hour. He is a Public Health Professional working in development sector. Dr. Tareq, a medical graduate, is a member of Public Health Association of Bangladesh and a Member of the Governing Council of World Federation of Public Health Associations (WFPHA), a J2J Fellow on HIV/AIDS and a member of the International AIDS Society. To know more about Dr. Tareq, please visit his personal website or simply Google his name.
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